I am including a copy paste from my book "Dementia Care Companion" covering this subject:
“I Want to Go Home” Over time, as it becomes harder to find the right words, the patient will rely increasingly on word substitutions. Sometimes, a word is just meant as a placeholder in a sentence, like saying “Give me my pants” when they want their shoes. At other times, it is the feeling behind the words, rather than their literal meaning, that is intended, for example, “I want to go home.” When the patient says that they want to go home, this is not always due to confusion. Rather, the patient may be expressing a desire for love, peace, comfort, and security that they associate with home. When the patient feels anxious and isolated, when they feel that no one understands them, that everyone is reprimanding them, bossing them around, or asking them to do the impossible, “I want to go home” expresses a need for escape to a familiar shelter, a longing for the warmth and security that they associate with home. · Do not try to convince the patient that they are already home. Instead, look for the sentiment behind the words “I want to go home.” · Apply the techniques you’d use to get to the root cause of behavioral problems. Look for unmet needs, environmental issues, and problems with patient-caregiver interactions. · Are the patient’s basic needs being met? Is the patient hungry, thirsty, or in pain? Are they bored? Do they have an infection? Are they constipated, or do they need to go to the bathroom? · Is the environment comfortable? Is it too warm or too cold, too bright or too dark, too noisy, or crowded? · Are patient-caregiver interactions thoughtful and comforting? Does the patient feel safe? Do they feel loved, cared for, and accepted? Are they comforted with hugs, caresses, companionship, and words of encouragement? · Go with the flow and redirect. Say something like, “Okay, we’ll go soon,” and then distract the patient by doing something pleasant that takes their mind off of wanting to go home.
5 things to remember when someone with dementia is asking to go home
1. Avoid arguing about whether they are already ‘home' For a person with dementia, the term 'home' may describe something more than the place they currently live. Often when a person with dementia asks to go home it refers to the sense of ’home’ rather than home itself.
‘Home’ may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.
It’s usually best not to try to reason or disagree with the person about where their home is. If they don't recognise their environment as 'home' at that moment, then for that moment, it isn't home.
Advice What not to say to somebody with dementia Try to understand and acknowledge the feelings behind the wish to go home. Find out where 'home' is for them - it might not be the last place they lived. It could be where they lived before moving recently or it could be somewhere from their distant past.
Often people with dementia describe 'home' as a pleasant, peaceful or idyllic place where they were happy. They could be encouraged to talk about why they were happy there. This can give an idea as to what they might need to feel better.
2. Reassure them of their safety The desire to go home is probably the same desire anyone would have if we found ourselves in an unfamiliar place. Reassure the person verbally, and possibly with arm touches or handholding if this feels appropriate. Let the person know that they are safe. It may help to provide reassurance that the person is still cared about. They may be living somewhere different from where they lived before, and need to know they’re cared for.
3. Try diverting the conversation Keep a photograph album handy. This could be a physical book or photos on a tablet or smartphone. Sometimes looking at pictures from the past and being given the chance to reminisce will ease the person’s feelings of anxiety.
It might be best to avoid asking questions about the pictures or the past, instead trying to make comments: 'That looks like Uncle Fred. Granny told me about the time he....' Alternatively, you could try shifting the person's focus from home to something else - such as food, music, or other activities, such as going for a walk.
4. Establish whether or not they are feeling unhappy or lonely A person with dementia may want to 'go home' because of feelings of anxiety, insecurity, depression or fear.
Think about whether the person with dementia is happy or unhappy when they mention going home. If they are unhappy, it may be possible to discover why.
Like anyone, someone with dementia may act out of character to the people closest to them as a result of a bad mood or bad day.
5. Keep a log of when they are asking to go home Certain times of the day might be worse than others. What seems to be the common denominator about these times? Is it near meal times (and would a snack perhaps help)? Is it during times when the environment is noisier than usual? Is it later in the day and possibly due to ‘sundowning’? If you see a pattern, you can take steps to lessen or avoid some of the triggers.
After reading on this site about problems trying to correct memories, when my father asked me to take him home, I asked what he wanted to do there. He said that the crops needed planted. I then had a nice conversation with him about how he used to help on the farm (over 70 years ago). This also led me to tell him that the neighbor had already helped and the planting was done. This reassured him.
My 102 YO mom often says she’s “ready to go home”. By this, she means she is ready to die. We talk about how it is not up to us when we die, but that God has every day of our lives numbered. I tell her that God isn’t finished with her on earth yet, that He’s still working on her “room” in Heaven, and that we’ll just continue to have our conversations with God, letting Him know she’s ready! I am fortunate that she is still able to live in her own house, with every-other-day assistance from my sister and me for IADLs.
1. Okay, we will go soon. First we need to xxx (go shopping, have lunch, go for a walk in the garden, play a game, watch tv show).
2. I presume that this person is in a nursing home / facility and wants to go home. Now I reallize that maybe s/he is home and says they want to go home.
Sets up an argument [creates emotional distress]:
3. Do not argue.
4. Do not try to convince them they are home. 4a. Stay calm. (It is a learned response; be patient with yourself]
5. Say okay. I'll go back your suitcase (or pack something) ... then change the subject.
Ask MD about medication (adjustment). Expect this behavior to go on as the person is feeling lost, alone, not aware of where they are. So, you need to:
1. Give yourself breaks.
2. Agree (as above)
3. Perhaps give a massage or get a massage therapist in (or give a hand or foot massage). The feelings could also be from anxiety, feeling bored, confused - all of these feelings due to brain chemistry changing / cells dying.
4. Distractions.
5. Visit TEEPA SNOW website. She has lots of tools / techniques on how to talk to people with dementia. She is a master. Watch her You Tubes. Take some of her classes. (I did webinars with her for 1-1/2+ years).
First I would try to act as if it were a perfectly normal. Don't create an atmosphere of alarm. Try taking him for a short drive or walk around the block. If the question still is there, try to divert the attention to a trip tomorrow.
Mom asks me that question every week. I ask her where is home? She will sometimes say the city she was raised in, sometimes my brothers home where she lived for a few years…sometimes she says “I just do not know where I live”…where should I sleep?…...I take her to her pretty room at AL and tell her this is your apartment..thats your blue chair, those are your family pictures and she asks..”Can I sleep here” …..yes mom you can sleep here! I paid the rent for you… …that settles her down..there are no easy answers! Good Luck..
Home is many things. Homes can mean safety Homes can be a place where you lived with your spouse and raised a family. Homes can mean happy memories (sad ones as well)
So maybe when mom says "I want to go home" she means any number of things or feelings. Try these Reassure mom that she is safe. Tell her that you love her. Then redirect to a task or activity that she likes. Or if it is time for a bit of a snack and a drink.
So I'd just say maybe tomorrow we will and for now we are just going to relax and enjoy this home. And change the subject
“I Want to Go Home”
Over time, as it becomes harder to find the right words, the patient will rely increasingly on word substitutions. Sometimes, a word is just meant as a placeholder in a sentence, like saying “Give me my pants” when they want their shoes. At other times, it is the feeling behind the words, rather than their literal meaning, that is intended, for example, “I want to go home.”
When the patient says that they want to go home, this is not always due to confusion. Rather, the patient may be expressing a desire for love, peace, comfort, and security that they associate with home. When the patient feels anxious and isolated, when they feel that no one understands them, that everyone is reprimanding them, bossing them around, or asking them to do the impossible, “I want to go home” expresses a need for escape to a familiar shelter, a longing for the warmth and security that they associate with home.
· Do not try to convince the patient that they are already home. Instead, look for the sentiment behind the words “I want to go home.”
· Apply the techniques you’d use to get to the root cause of behavioral problems. Look for unmet needs, environmental issues, and problems with patient-caregiver interactions.
· Are the patient’s basic needs being met? Is the patient hungry, thirsty, or in pain? Are they bored? Do they have an infection? Are they constipated, or do they need to go to the bathroom?
· Is the environment comfortable? Is it too warm or too cold, too bright or too dark, too noisy, or crowded?
· Are patient-caregiver interactions thoughtful and comforting? Does the patient feel safe? Do they feel loved, cared for, and accepted? Are they comforted with hugs, caresses, companionship, and words of encouragement?
· Go with the flow and redirect. Say something like, “Okay, we’ll go soon,” and then distract the patient by doing something pleasant that takes their mind off of wanting to go home.
1. Avoid arguing about whether they are already ‘home'
For a person with dementia, the term 'home' may describe something more than the place they currently live. Often when a person with dementia asks to go home it refers to the sense of ’home’ rather than home itself.
‘Home’ may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.
It’s usually best not to try to reason or disagree with the person about where their home is.
If they don't recognise their environment as 'home' at that moment, then for that moment, it isn't home.
Advice
What not to say to somebody with dementia
Try to understand and acknowledge the feelings behind the wish to go home. Find out where 'home' is for them - it might not be the last place they lived. It could be where they lived before moving recently or it could be somewhere from their distant past.
Often people with dementia describe 'home' as a pleasant, peaceful or idyllic place where they were happy. They could be encouraged to talk about why they were happy there. This can give an idea as to what they might need to feel better.
2. Reassure them of their safety
The desire to go home is probably the same desire anyone would have if we found ourselves in an unfamiliar place.
Reassure the person verbally, and possibly with arm touches or handholding if this feels appropriate. Let the person know that they are safe.
It may help to provide reassurance that the person is still cared about. They may be living somewhere different from where they lived before, and need to know they’re cared for.
3. Try diverting the conversation
Keep a photograph album handy. This could be a physical book or photos on a tablet or smartphone. Sometimes looking at pictures from the past and being given the chance to reminisce will ease the person’s feelings of anxiety.
It might be best to avoid asking questions about the pictures or the past, instead trying to make comments: 'That looks like Uncle Fred. Granny told me about the time he....'
Alternatively, you could try shifting the person's focus from home to something else - such as food, music, or other activities, such as going for a walk.
4. Establish whether or not they are feeling unhappy or lonely
A person with dementia may want to 'go home' because of feelings of anxiety, insecurity, depression or fear.
Think about whether the person with dementia is happy or unhappy when they mention going home. If they are unhappy, it may be possible to discover why.
Like anyone, someone with dementia may act out of character to the people closest to them as a result of a bad mood or bad day.
5. Keep a log of when they are asking to go home
Certain times of the day might be worse than others. What seems to be the common denominator about these times? Is it near meal times (and would a snack perhaps help)? Is it during times when the environment is noisier than usual? Is it later in the day and possibly due to ‘sundowning’?
If you see a pattern, you can take steps to lessen or avoid some of the triggers.
me to tell him that the neighbor had already helped and the planting was done. This reassured him.
Possible responses:
1. Okay, we will go soon. First we need to xxx (go shopping, have lunch, go for a walk in the garden, play a game, watch tv show).
2. I presume that this person is in a nursing home / facility and wants to go home. Now I reallize that maybe s/he is home and says they want to go home.
Sets up an argument [creates emotional distress]:
3. Do not argue.
4. Do not try to convince them they are home.
4a. Stay calm. (It is a learned response; be patient with yourself]
5. Say okay. I'll go back your suitcase (or pack something) ... then change the subject.
Ask MD about medication (adjustment).
Expect this behavior to go on as the person is feeling lost, alone, not aware of where they are. So, you need to:
1. Give yourself breaks.
2. Agree (as above)
3. Perhaps give a massage or get a massage therapist in (or give a hand or foot massage). The feelings could also be from anxiety, feeling bored, confused - all of these feelings due to brain chemistry changing / cells dying.
4. Distractions.
5. Visit TEEPA SNOW website. She has lots of tools / techniques on how to talk to people with dementia. She is a master. Watch her You Tubes. Take some of her classes. (I did webinars with her for 1-1/2+ years).
Gena / Touch Matters
Homes can mean safety
Homes can be a place where you lived with your spouse and raised a family.
Homes can mean happy memories (sad ones as well)
So maybe when mom says "I want to go home" she means any number of things or feelings.
Try these
Reassure mom that she is safe.
Tell her that you love her.
Then redirect to a task or activity that she likes. Or if it is time for a bit of a snack and a drink.